Bill requires coverage of egg, sperm freezing for cancer patients

Melissa Thompson poses for a photo inside her building in Stamford on Thursday. Thompson, who was diagnosed with stage three breast cancer weeks after giving birth to her daughter, spearheaded an effort to get a bill passed in the state legislature requiring health insurance coverage for fertility preservation for insureds diagnosed with cancer. less

Melissa Thompson poses for a photo inside her building in Stamford on Thursday. Thompson, who was diagnosed with stage three breast cancer weeks after giving birth to her daughter, spearheaded an effort to get ... more

Photo: Michael Cummo / Hearst Connecticut Media

Photo: Michael Cummo / Hearst Connecticut Media

Image
1of/9

Caption

Close

Image 1 of 9

Melissa Thompson poses for a photo inside her building in Stamford on Thursday. Thompson, who was diagnosed with stage three breast cancer weeks after giving birth to her daughter, spearheaded an effort to get a bill passed in the state legislature requiring health insurance coverage for fertility preservation for insureds diagnosed with cancer. less

Melissa Thompson poses for a photo inside her building in Stamford on Thursday. Thompson, who was diagnosed with stage three breast cancer weeks after giving birth to her daughter, spearheaded an effort to get ... more

Photo: Michael Cummo / Hearst Connecticut Media

Bill requires coverage of egg, sperm freezing for cancer patients

1 / 9

Back to Gallery

Just five weeks after giving birth to her daughter Poppy, Melissa Thompson was diagnosed with stage three breast cancer.

It was shocking, terrifying news for the Stamford resident, now 34. And it quickly got even more fraught. “I was told that I needed to preserve my fertility if I wanted more children,” she said.

That meant freezing her eggs, an expensive procedure that she was initially told her insurance would cover. But, about midway through the process, her insurer contacted her and said they weren’t covering the procedure after all. “They told me they were rescinding the authorization because I had cancer, not infertility,” she said.

The distinction made no sense to her.

“I was facing chemotherapy, which was known to cause infertility,” Thompson said.

The experience was painful and demoralizing, but it ignited a passion in Thompson to change the system. She soon became an advocate for state legislation requiring health insurance coverage for patients who wish to preserve their sperm or eggs following a cancer diagnosis. The legislation had languished for several years before Thompson heard about it.

The bill cleared the state legislature late last month, and many credit Thompson for its success, including State Rep. Matthew Lesser, D-Middletown, who introduced the original bill. Lesser, a cancer survivor who chose to preserve his sperm before treatment, said he has heard of cancer patients delaying treatments so they could start a family, or opting for less effective cancer treatments to preserve their fertility. Because of Thompson, he said, that’s no longer a choice Connecticut residents will have to make.

“It’s incredible what one dedicated individual can do,” he said.

A ‘double blow’

Often, cancer diagnosis comes when someone is still in his or her childbearing years — or haven’t even reached that stage of life. According to the National Cancer Institute, about 70,000 people aged 15 to 39 are diagnosed with cancer every year in the United States, as are roughly 10,000 children 14 and younger.

For these patients, being told they have cancer can be a “psychological double blow,” said Dr. Joshua Hurwitz, a partner at Reproductive Medicine Associates, which has offices in Trumbull, Danbury, Norwalk and Stamford. The clinic — which is not the one Thompson used — has long advocated for coverage for cancer patients.

“First, these patients learn they have cancer, then they learn that the treatment they will receive could end their fertility,” said Hurwitz, director of fertility preservation for the Western Connecticut Health Network, which includes Danbury, New Milford and Norwalk hospitals. “I don’t think a patient should have to choose between life-saving cancer treatments and having a baby afterward.”

In 2005, Connecticut passed legislation requiring most health policies to cover “medically necessary costs of diagnosing and treating infertility.” It’s one of 15 states to have such a policy. In 2016, the state removed an age restriction from the mandate, which had prevented fertility coverage for women 40 and older. But obstacles to coverage remained for some, including cancer patients who wished to freeze their genetic material.

When Thompson learned insurance wouldn’t cover her fertility preservation, she already owed $12,000, which she charged to her credit card. For men, the cost is much less. Lesser said freezing his sperm cost him about $400.

Thompson said, when she was told she had to pay the $12,000, she was in the midst of cancer treatments that had left her mentally and physically exhausted. “By the time I was strong enough to look into it, the window to file an appeal had closed,” she said.

She contacted her state representative, Caroline Simmons, D-Stamford, to see if she had any options. That’s when Simmons told Thompson about Lesser’s legislation.

“Frankly, it hadn’t been all that successful, and we couldn’t make it happen,” Lesser said.

But when Lesser reintroduced the bill this session, Thompson was by his side, telling her story. She was determined to make the bill a success.

“This is an issue that transcends parties,” she said. “Everybody can connect with it in some way.”

Some concerns

Some were concerned about the potential impact the legislation would have on health insurance premiums. The Connecticut Business & Industry Association submitted testimony cautioning against health benefit mandates, or requirements to cover certain services, arguing that these policies “restrict choice and increase price.”

But Thompson and Lesser said the legislation isn’t technically a mandate, as what it primarily does is redefine “infertility.” Previously, it was defined as “the condition of a presumably healthy individual, who is unable to conceive or produce conception or sustain a successful pregnancy during a one-year period.” The new legislation removes the words “presumably healthy” from the definition, and extends it to include those for whom fertility services are “medically necessary.” This would include cancer patients.

In his testimony, Lesser said it is still unknown what effect the legislation could have on health insurance costs in the coming year.

The response to the bill was largely positive, with medical groups, including the Connecticut State Medical Society, testifying in favor of it. The society has long held the opinion that a person’s quality of life — including the ability to have children — should not be harmed by a cancer diagnosis, said Ken Ferrucci, the society’s senior vice president of government affairs.